Category Archives: Commentary

Technical Glitch / Learning Opportunity

Yesterday I tried to post a 38 minute video of a talk I gave on the history of Naval Hospital Mare Island, California, the Navy’s first Hospital on the west coast. The video transfer didn’t “take”, however, so back to the drawing board.

The video does appear on a Facebook page of the same name: Of Ships and Surgeons. Go take a look if you can.

Our Shrinking Historical Patrimony

I’ve posted on this topic before, noting that the ravages of time and disasters (both natural and man made) seemingly inexorably erode the historical landscape. I argued that historians should lead (or at least actively support) efforts for the preservation of historical landmarks and other artifacts.

Just recently I learned of the possible imminent demolition of such an artifact – the 1920s Spanish-revival style former Oak Knoll Country Club and Officers’ Club for the Oakland (California) Naval Hospital. 

U.S. Naval Hospital Oakland – “Oak Knoll” to Bay Area locals – sprang into existence in 1942 as part of Navy Surgeon General Ross McIntire’s massive World War 2 expansion of Navy medical facilities.* Even before war broke out McIntire, realized that the Naval Hospital at Mare Island – the Navy’s first on the west coast – was too old, too small and vulnerable to collateral damage from any Japanese air strike on the huge shipyard nearby. He directed 12th Naval District officials to cast about for a replacement location, one that would be convenient to Alameda Island in the San Francisco Bay (where casualties from the war in the Pacific would be landed by ship and later plane), and capacious enough for a very large facility. McIntire’s agents hit upon the Oak Knoll Country Club, a luxurious facility that had gone bankrupt as a result of the Great Depression. Its facilities, including the lovely Club building, had lain fallow for several years. In April 1942, the government began the proceedings necessary to procure the property. The hospital received its first patients in August, and by the end of the war was caring for 3000 or more wounded and sick service personnel. The old Clubhouse was repurposed as the hospital Officers’ Club – a dining facility and watering hole for doctors, nurses and other officers serving in or visiting the facility and the Bay Area.

Oakland Naval Hospital, around 1945. Officers’ Club ? in lower right corner. Naval Hospital San Leandro , purpose-built to care for psychiatric casualties, is in the background.

The hospital flourished, especially after the Mare Island hospital closed in 1957. Its staff of doctors, nurses and corpsmen and corps waves cared for casualties of the Korean and Vietnam wars, and for legions of military family members and retirees. The “temporary” ward buildings you see in the image above were finally replaced with a new “Moderne”-style tower structure in 1968. Your correspondent drilled as a Reservist in one of those “temporary” buildings, in the 1980s. – Ed. The hospital closed in 1996 as part of the “BRAC”^ process that shuttered military bases and facilities all across the country.

Today, all that remains on the 160+ acre site is the Country Club / Officers’ Club. Developers had cleared the land by the early 2000s for a large housing area. At the time they expressed the intent of preserving the structure for use as a community center. This project came to a halt in 2008, a victim of the Great Recession. Now, developers are proceeding, but this time they express the intent to demolish the Club.

Naval Hospital Oakland Officers’ Club building, neglected. Next: demolition?

Facing the possibility that this lovely and historical structure may go away, a group of Oakland residents – Oakland Heritage Alliance – are mobilizing the forces to lobby Oakland city officials for its preservation, restoration and adaptive reuse. A piece of our historical patrimony hangs in the balance. Hearings are scheduled for some time this spring.

*U.S. Naval Hospitals numbered 19 at the outset of World War 2. One, at Cañacao in the Philippines, was lost early to the Japanese invasion. By the end of the war, the Navy was operating 99 hospitals. This number included country clubs, hotels, college dormitories “taken up from trade” or purchased outright (this is another story), and large, semi-permanent base, mobile and fleet hospitals located typically in “exotic” locations like Tutuila, American Samoa (e.g., Mobile Hospital No 3) or Hollandia, New Guinea (e.g., Base Hospital No 17).

^BRAC – [Defense] Base Realignment And Closure – the most recent in a long string of United States military base closures that began shortly after World War II. In all, something like 350 bases and installations went out of business in the five rounds (1988, 1991, 1993, 1995, 2005) of the BRAC process.

(C)2016 Thomas L Snyder, MD

Erosion of the Historical Landscape

“Fires Continue to Plague Historic Forts” is the headline in the most recent number (318) of Headquarters Heliogram, the Council on America’s Military Past newsletter. The article then details damage to structures at Fort Wayne (Indiana), Fort Niagara (upstate New York), and Fort Mifflin (near Philadelphia) over the past year. In my own backyard, the 6.0 American Canyon earthquake in August damaged several historic buildings – including the Museum and the main hospital structure – in the Mare Island Navy Yard historical area of northern California.  The Heliogram article closes: “Fires and vandalism [I’d add “nature and neglect”] seem to be a constant threat to historic sites. While some have around-the-clock security or alarm systems, many do not due to technical or financial challenges. Making repairs also costs money and many sites don’t have adequate insurance or reserves to cover the cost of [repairs of] damage.” City and other governmental agencies are often as dangerous to our history as “fires and vandalism”. My own city of Vallejo saw the wholesale destruction of historical structures – including a lovely and iconic Carnegie library – in its haste for urban renewal in the late 1960s.

Carnegie Exterior

Carnegie Library Vallejo CA. Opened 1904. Demolished 1969. Photo Courtesy Vallejo Naval and Historical Museum via http://www.carnegie-libraries.org/california/vallejo.html

Carnegie interior

Carnegie Library Vallejo CA. Interior. Image Courtesy Vallejo Naval and Historical Museum via http://www.carnegie-libraries.org/california/vallejo.html. Opened in 1904, it was demolished in an ill-advised flurry of downtown urban renewal in 1969.

 

And so we see that the inevitable result of the insults of time, nature, people and events – plus the lack of resources or interest to restore, preserve and protect them –  is the gradual degradation and disappearance of the most compelling records of our history – the physical evidence as represented by structures and landscapes.

So, what should historians – professional, academic and amateur – do?

First, of course, is to do what historians have always done: research and collect the information, write about it, analyze it, and make sure the historical structure, event, person, is made part of the historical record. While material published by traditional means – be it on stone, clay or paper – is pretty durable, especially if published in periodicals and books published by the hundreds or thousands, electronic publishing is problematic. Will the electronic format change? Will electronic storage “tanks” fall into disuse and neglect as time and technology move on? (The whole issue of archival storage is a topic for another day.)

Second, historians need to “sell” history to a public very interested in their past. Lectures given at libraries and museums are a natural. Lectures given to local service clubs like Rotary or Soroptimists deliver a message to community business and professional leaders, people with influence and money, people for whom “getting things done” is a way of life. Want to raise money or workers to restore a local icon? Get the Rotarians involved! Another way to deliver history to the public is by being a docent at a museum, park or historic site. Docents make history come alive by their enthusiastic and knowledgable story telling and explanations. My personal favorite is giving walking tours of historic sites; there’s something compelling about walking in the steps of the people who were part of the history you’re telling.

Third, historians need to become involved in the “politics” of restoration/reservation/protection. This may take the form of serving on the Commission that’s responsible for overseeing a community’s heritage or landmarks. Historians who give testimony or who advocate for preservation bring powerful and respected voices to any discussion about preserving our past. I know a local historian who quite literally single-handedly faced down developers and sympathetic local legislators to preserve a significant historic resource that was just weeks from being demolished for a construction project. (She gives credit to the historical society, but the reality is, she was one person – tenacious to be sure – who saved an important historical resource.) Public advocacy works!

Finally, historians can learn how to establish tax-exempt foundations to support preservation efforts of important resources. It’s easy to do – Nolo Press publish a handy go-by that really works. I know because I’ve set up three 501(c)(3) non-profits using their publication. Of course the non-profit corporation is just the first step. After that, you have to go out and beat the bushes for money. See steps two and three above. And recruit friends, colleagues and relatives to help out!

There you have it. Historians working to preserve our past by researching and publishing it, by selling it to a public hungry to know more, by advocating for restoration/preservation/protection at a local governmental level, and by raising funds for those efforts. No small order, but committed action does get results.

Tell us what you have done in your community. Give us your best ideas and best practices for restoring/preserving/protecting our past. Post your comments and I’ll make sure our readers see them.

©2014 Thomas L Snyder, MD

 

Whither the History of Medicine (Again…)

Last month, in an article entitled Offline: The moribund body of medical history, Lancet Editor-in-Chief Richard Horton opined that, since the 1980s, medical historians have lost the bubble on “important issues of the past as they might relate to the present.”  He declaims that the academics dominating the field have somehow forgotten that  the esteemed Owsei Temkin (a father of the study of medical history in the west) related the history of medicine to the social, cultural, political and economic milieu in which the art and science are practiced. Temkin, he says, felt that historians, more than mere toters-up of medical events, should interpret the ebbs and flows of this most human of human endeavors. Citing what he sees as a dearth of current relevant historical inquiry, Horton’s damning peroration is: “So where are the historians of today to illuminate the past as we struggle with the aggressive commercialisation of medicine, failures of professional leadership, notions of free will and death, misuse of medicines, paralysis in public health policy, or catastrophic failures of care? They appear to have evaporated, leaving a residue of dead and inert dust.”

University of Manchester medical historian Carsten Timmerman, replying in the Guardian blog The H Word, begged to differ. He lists several recent works that offer the kind of inquiry Horton despairs of seeing ever again, and points to his own bookshelf as proof. But here, Timmerman admits, may lie the problem. The books on his shelf are probably on the shelves of other medical historians, and that’s about all. He allows that there are so many historians of medicine now that they mostly content themselves by discussing the high topics of the day – with each other. So what Horton sees as a coffin may simply be an historical echo chamber!

Timmerman offers an answer to this problem of communication, and it’s one that will be familiar to readers of this blog: make your historical work relevant by talking to doctors and other health care givers. To this I would add, talk to the general populace by participating in the debate about social and medical policy through op-ed articles, letters to the editor, media interviews, and talks at your local Rotary club.

©2014 Thomas L Snyder, MD

A View of the People’s Liberation Army Navy (PLAN) Hospital Ship ”Peace Ark”

I’ve written about hospital ships before. Since then, I have privately wondered if there was a combat-casualty role for them in the modern world of sophisticated forward combat care hospitals and air transport to evacuate the most severe combat casualties to the highest levels of care. Moreover, big gray ships are increasingly being fitted out with sophisticated medical capabilities. In my posting on hospital ships, I mentioned the German Berlin-class Fleet Support Ship as an example. US amphibious ships, intended to provide support for Marine Corps operations, are all fitted out for surgery; the new USS America (LHA 6) will have expanded medical spaces in view with her capability to take on casualties by helicopter evacuation.(1) With this apparent move away from big white ships with big red crosses, whither hospital ships?

Peoples' Liberation Army Navy Hospital Ship "Peace Ark". Xinhoa Photo

People’s Liberation Army Navy Hospital Ship “Peace Ark”. (Xinhua Photo; Source: USNI News)

Enter the PLAN’s Peace Ark. This bwswbrc, the only Type 920 Hospital Ship in the Chinese inventory, possibly the only active PLAN hospital ship of any class, made a dramatic appearance at the recently concluded RIMPAC 2014 exercises. The Naval Institute news blog carried a nice article on the ship on 23 July.(2) Featured was Senior Captain Sun Tao, identified as the officer in charge of the ship’s medical detachment. Captain Sun told his interviewers that, when not under way, the ship carries a crew of 113 and a 20 person medical detachment. When at sea, the crew would increase to 300+ and the medical detachment to around 100.

While capable of receiving war casualties by helicopter, boat or high line, it appears that the ship has been used mainly for humanitarian / public affairs visits since it was first deployed beyond Chinese waters in 2010. Her most recent overseas activity was a humanitarian mission to the Philippines after super typhoon Haiyan.

The ship is fitted out with 8 operating rooms, 20 intensive care beds and 300 general care beds. Apparently, much of her medical gear is manufactured by the Dutch firm Phillips. She is equipped with an ultrasound suite, and CT and x-ray

Senior Captain Sun Demonstrates an Operating Room in PLAN Hospital Ship "Peace Ark" (Source: USNI News)

Senior Captain Sun Demonstrates an Operating Room in PLAN Hospital Ship “Peace Ark” (Source: USNI News)

capabilities. Interestingly, even her life boats are equipped to handle up to 18 stretchers or 24 ambulatory patients. Captain Sun showed off a gynecological examining room; this was a space, he said, that was particularly useful during humanitarian missions.

Given that navies of the world are apparently building ever more med-surg capability into big gray ships that are capable of protecting themselves against terrorist attacks, one is left wondering if hospital ships have any military utility at all. On the other hand, the dramatic good-will advertising power of a big white ship with big red crosses showing up in times of humanitarian need, makes the civilian utility of such vessels pretty obvious.

©2014 Thomas L Snyder, MD

(1) Defense Media Network Article “USS America (LHA 6) – a different kind of gator”, accessed 2014August06

(2) USNI News Article “Peace Ark: Onboard China’s Hospital Ship”, accessed 2014July24

On Reaching Age 70

In a 1905 speech marking his departure from the Johns Hopkins medical faculty, the revered William Osler offered that he had “two fixed ideas” about age. The first of these “is the comparative uselessness of men above forty years of age”, evidence for which, as he saw it, was the paucity “of human achievement in action, in science, in art, in literature -” arising from men above that age. He went on, “[t]he effective, moving, vitalizing work of the world is done between ages twenty-five and forty – these fifteen golden years of plenty, the anabolic or constructive period, in which there is always a balance in the mental bank and the credit is still good.”

Osler’s second fixed idea “is the uselessness of men above sixty years of age, and the incalculable benefit it would be in commercial, political, and in professional life if, as a matter of course, men stopped work at this age.” Osler quotes Donne stating that in ancient Rome, men at age sixty and beyond were denied the vote and were referred to as Depontani “because the way to the senate was per pontem [by way of the bridge], and they were not permitted to come thither.” He then cited – tongue firmly in cheek, I believe – Anthony Trollope’s novel “The Fixed Period” where that author advocates for “the admirable scheme of a college into which at sixty men retired for a year of contemplation before a peaceful departure by chloroform[!]“.

I retired – at Osler’s prescribed age 60 – from a very busy practice of urology. Part of my motivation was that the specialty was undergoing a sea change in surgical technique – to a much more laparoscope-based approach. I expected this would take me a good 3 or 4 years to master, just about in time to retire anyway. Better to make room for younger people brought up in the new surgical environment.

"The Astronomer" by Vermeer  (Credit: http://vermeer0708.wordpress.com/about/)
“The Astronomer” by Vermeer
(Credit: http://vermeer0708.wordpress.com/about/)

But no chloroform exit for me! In fact, enjoying a “comfortable” retirement has given me a sense of what it must have been like in 17th and 18th century Europe when men of means, who did not have to work for the next meal, could spend their mental energy immersed in artistic, literary or scientific endeavors. And thus it’s been for me in the intervening 10 years: I’ve researched and written some history and some commentary, In 2003, I founded the Society for the History of Navy Medicine to serve as a scholarly home for people interested in research, study and publication in the history of maritime medicine. For the last 2 years, I wrote a nearly weekly blog on various medical history topics (I just “retired” from these last two endeavors, on my 70th birthday). And then, there is “Community Involvement”: a Rotary club presidency, reorganizing the Fleet Admiral Nimitz Chapter of the Association of the United States Navy after decades of unconscionable silence; leadership in historical organizations both local and national; and recently, chairing a committee to establish a Poet Laureate program for my city.

One of the saddest things I observed in my practice were men whose lives essentially ended with retirement. With no “purpose” in life, these men descended into sometimes dreadful depressions. But for no reason! I believe that, in any community, all one has to do is let it be known that one is retired, and the phone will ring off the hook with offers of opportunity for community service. This is often joyful work, done alongside other people of good will who are doing it simply because they want to!

So, at age 70, at the beginning of the “third half” of my life, my calendar is “booked” right up through my 75th year. If I were to die tomorrow, I’d do so satisfied with a life well lived – but really pissed because there’s so much more I want to do!

This article was originally posted to my blog “Of Surgeons and the Sea” on 30 April 2013

©2013, 2014 Thomas L Snyder, MD

 

Of Ships and Surgeons Going “Private”

I started this blog when I was the Executive Director (Founding) of the Society for the History of Navy Medicine. I intended the blog to be the public voice of the Society, and so it was during my directorship of six years. When the Society’s next Director, Jim Dolbow took the helm, he created a blog specifically (and appropriately) for Society news and events. I suspect that the Society’s third Executive Director, Professor Annette Finley-Croswhite will expand the use of that site to get the Society’s word out. Given the firm establishment of the Society’s blog, I believe now’s a good time to take this blog, which is really my personal “historical” statement, “private”. Henceforth, the blog will be my personal means of communicating maritime medical history and commentary to the world.

After posting an article (typically of 400 – 600 words, and usually a researched historical piece) a week here for nearly two and a half years, my brain was pretty much sucked dry – I REALLY respect professional writers who must work to a weekly deadline for a whole career! – and the muse left me. But now, after a year’s sabbatical, I think it’s time to tiptoe back into the arena. Accordingly, I will post such occasional piece here, either history or commentary, as I am moved to produce. I hope you gain some benefit from these scriblings

The Blogger-in-Chief

(c) 2014 Thomas L Snyder, MD

Guest Blogger: Chaplain Dave Thompson on Non-Combat Casualties

Our blog-friend Chaplain Dave Thompson joins us for another post. This time, he writes about the matter of non-combat casualties of war since the Civil War.

As you are well aware, I have been trying to tell the story of disease in our wars…especially WW I ( The Great Flu Pandemic of 1918 in WW I), which cost more lives than combat in that conflict, For every American war before WW II, this largely was the case… death to disease trumped all combat deaths in these conflicts!.

In the Civil War a similar phenomenon of more deaths to disease than combat occurred (see: http://www.civilwarhome.com/casualties.htm ). Of the 618,000 soldiers who died in the Civil War, 2/3rd’s of them died of disease (414,152) and only 1/3 died in combat (204,070).

Then there were an additional 24,866 soldiers who died in prison due to disease and mistreatment as POW’s by both Union and Confederate forces!Outside of McKinley Kantor’s Pulitzer Prize Winning novel of a Confederate POW camp in SW Georgia,  Andersonville (see: http://www.amazon.com/Andersonville-Plume-MacKinlay-Kantor/dp/0452269563/ref=sr_1_1?s=books&ie=UTF8&qid=1362578878&sr=1-1&keywords=andersonville ), much of  the darker story of neglectful treatment of POW’s in the Civil War, on both the Union and Confederate sides, is rarely told today in general American History texts covering the 19th Century. See the Camp Sumter/Andersonville POW Prison story ( http://www.nps.gov/ande/historyculture/camp_sumter.htm ), where 45,000 union POW’s were imprisoned (see:http://www.nps.gov/ande/historyculture/camp_sumter.htm ), and where 13,000 died of a variety of diseases (see: http://www.nps.gov/ande/historyculture/causesofdeath.htm ).

Andersonville’s decrepit conditions were chronicled in the diary on P.O.W Newell Burch. Burch of the 154th New York Infantry, was captured the first day of the Battle of Gettysburg and imprisoned at Belle Isle and then Andersonville. He is credited with being the longest held Union Soldier during the Civil War, a total of 661 days in Confederate hands (usgwarchives.net). His diary is currently possessed by the Minnesota Historical Society.

The breakdown of casualties to disease and battles was quite interesting. Again, the stunning statistics of disease in war (over 66% of Civil War soldiers died in bed not in battle) that is often airbrushed out of our American histories, only telling the “glory” side of war.  More Civil War soldiers died of dysentery and diarrhea alone (way over 200,000) than were killed in all the battles and battlefields of the Civil War. Yet, you don’t see that kind of detail dealing with sickness in Civil War museum exhibits or re-enactments of battles…no field hospitals are built in rear areas in these re-enactments, nor any effort made to tell the general public the story of disease that accounted for the deaths of 2/3 of all the Civil War deaths in the Union and Confederate Armies. Many Americans are ignorant of this fact as we near the 150th Anniversary of the Civil War.

The “other war” against disease in conflicts is the kind of military history that is not talked about a lot in our “battle-centric” telling of war stories. Fundamentally, I sense, especially among military historians a problem in methods of historiography which focuses on battles as the easiest and most interesting things to report in a conflict, as well as an easy way to add up winners and losers by territory conquered or numbers killed (KIA) or  wounded (WIA). Meanwhile, lurking in the background are less jazzy statistics, like death dealing diseases in rear area cantonments, that cumulatively would trump the numbers of any combat casualties of a particular battle, campaign, or war.

Thus, we often ignore this larger background story of disease in war that dismally claims massive numbers of victims by a 2-1 margin in rear area field and general hospitals and POW camps, because it may have little to do with a 2 or 3 day battle like the Battle of Gettysburg. Unless a disease struck in the middle of a battle (like the 1918 Flu Pandemic did at the height of the Meuse Argonne Campaign in WW I, where General Pershing’s AEF was being decimated by this malady that made so many troops ineffective in  that battle), little is ever said in the course of a war about the role of disease in a war (except that written by medical historians and buried in medical record archives of the Army and Navy). Only in long Civil War sieges like that of Vicksburg or St. Petersburg, or the discovery of terrible health conditions in POW camps, would reports of sickness creep into a battle history, and then only in a sentence or paragraph of historical commentary, before getting back to what really was interesting…the movement of the chess pieces of armies and stories of bravery of solders, marines or sailors in combat.

Yet at the end of the war, when you add all the casualties related to cause of  death, we are shocked to discover the overwhelming numbers of those who lost their lives to disease…and a fair minded person asks, “where did that come from?” This big under-reported story of disease during the progress of a war is often ignored in our battle-centric focus of war reporting and military history inquiry, causing this “end of war statistic” to jump out at us after the war is over… but the military histories have already been written excluding this stark fact.

This dismal and boring aspect of disease in war largely goes under-reported in war…just like the story of logistics in war…the thousands of logistics ships and convoy escort ships that kept our forces going for four years to Europe and across the Pacific in WW II (a really big story of one of the main reasons we won WW II, which was lost in the historical glitter and clutter of reporting only 2 day to a week battles at sea…at Midway, Coral Sea, the “Slot” off of Guadalcanal, and Philippine Sea…or the terrible Pacific Island campaigns fought by sailors and marines that each took several weeks to a month per island). My eyes were opened to this little told “boring” logistical history, when I served on the USS Sacrament (AOE-1) that kept a whole aircraft carrier battle group going in beans, bullets/bombs and ship and jet fuel and supplies and mail  for a deployment in the Western Pacific and Indian Oceans (see: http://en.wikipedia.org/wiki/USS_Sacramento_%28AOE-1%29 ). Wars and combat operations would grind to a halt in weeks without this logistical tail working well. Rarely is that story told in our histories.

You are then struck with the challenge of historiography…how we select what we report on and what we ignore in our telling of military history. My sense is disease has not been given equal billing…or at least paid its due, in many of our American war chronicles of military history. It would make a great topic at a convention of military historians…and hopefully the presenter would not be thrown out of the presentation room for pressing for better reporting of this often lost story of the “other war” with disease that goes on in every one of our conflicts. The diseases change from war to war, but the challenge remains: Today we still face the danger of a variant of the 1918 flu pandemic bug getting away for us with CDC estimates of 100 million casualties…or “super drug resistant bugs” that can overwhelm a military hospital full of wounded military personnel and kill through infection many servicemen in record time.

As a former Navy Fleet Hospital Chaplain for a 500 bed combat zone fleet hospital,  I am impressed with this side of war that a lot of chaplains in military hospitals, as well as military doctors, nurses and medics/corpsmen, see with great regularity. It is not the glory side of war, but the gory side of war…with field and general hospitals filled with wounded warriors and service personnel stricken with all manner of death dealing diseases, soon forgotten as the battle moves on…and the story quickly moves on to the next battle or campaign.

The big lesson of history in our wars is the critical role our military medical departments play in dealing with wounds of war and infectious and debilitating diseases of the battlefield that can swallow large portions of armies and navies over the course of a war. It is a cautionary tale to military leaders not to neglect paying attention to disease in war that easily can kill more service personnel than any combat they may encounter. The record of history is clear that to ignore the medical aspect of military operations is to traverse into a deadly kill zone at one’s own peril with often devastating consequences. Only as we report this “other war” against disease and it becomes part of our military histories and learning from past conflicts, will we remain vigilant and prepared to fund and support efforts to deal with future medical challenges of disease on the battlefield.

Well, I have waxed long on the topic of disease getting better billing in our military histories. You are welcome to float this topic at a convention of military historians, but I am not sure what kind of reception you will receive. The “glory story of war” bias is alive and well among many military historians who see reporting diseases during wars as a distraction from what really is important in military history…reporting battles, campaigns and politics of war.

All I would hope would happen is an act of inclusion of reporting on disease among military historians…not exclusion …not diminishing the acts of valor or sacrifices of combat…but including better reporting of the role of disease in war in keeping with the scope and dimension of the problem… in the larger sphere of military history reporting.

©2013 David Thompson

Civil War Sailors Monument, Washington DC

Gina and I planned to go to the recent Inauguration, and we’d secured tickets through our Congressman’s office. But jury duty supervened. So we canceled our reservations and gave the tickets to our older son James, who lives in the DC suburb of Falls Church.

Peace Monument, Washington DC (Photo: Architect of the Capitol)

Peace Monument, Washington DC (Photo: Architect of the Capitol)

It turns out that our tickets permitted access to an area pretty close to the inaugural event, in a small traffic circle that contains one of James’s favorite Washington features, the little-known and under-appreciated “Peace Monument”, also known by the moniker cited in my title, above.

The monument was erected in 1877-78 to memorialize Union naval deaths at sea during the Civil War. Sculpted by Maine native Franklin Simmons – a well-known portrait sculptor of the time – it stands, at 44 feet, in Peace Circle at Pennsylvania Avenue and 1st Street NW. The top figures depict America (or Grief) holding her covered face against the shoulder of History, weeping in mourning. History holds a tablet inscribed, “They died that their country might live.” The major figures standing below are Victory – facing west – with an infant Mars, god of war, and an infant Neptune, god of the sea, lounging at her feet. Facing the capitol stands Peace, with symbols of peace and industry, science, literature and art resting at her feet.

The monument’s inscription reads, “In memory of the officers, seamen and marines of the United States Navy who fell in defense of the Union and liberty of their country, 1861-1865.” Admiral David D Porter, Civil War commander of gunboat fleets, conceived the monument and raised the necessary funds from private donors. The monument came under the cognizance of the Architect of the Capitol in 1973. Badly weathered and damaged after 100 years of neglect, it has since undergone three major restoration / preservation efforts, in 1990-1991, 1999 and 2010. Interestingly, several limbs of the statue’s figures were broken off when crowds climbed on them during the 2009 inauguration.

My son “discovered” the Peace Monument  in the 1990s and is a serious devoté. His favorite image of it is this one:

Peace Monument in Washington DC snow

Peace Monument in Washington DC snow (Photo: source unknown)

My source of information is the Architect of the Capitol website, http://aoc.gov/capitol-grounds/peace-monument, accessed 31 January 2013.

©2013 Thomas L Snyder

Book Review: Haycock and Archer, eds., “Health and Medicine at Sea, 1700-1900

Your correspondent is serving jury duty (a murder case – could run a month), and accordingly, has not been able to do his usual research to write. Fortunately, this week, Professor Timothy Walker sent me notice if the book review below with the note “this might be of interest to members of your Society [of the history of Navy Medicine]”. I suspect it will be of interest to readers of this blog, too. Thanks to the kind Professor! As you can see, the review comes to us by way of the h-net list serv from MSU.

From: H-Net Staff <revhelp@mail.h-net.msu.edu>
Date: Tue, Jan 8, 2013 at 3:19 AM
Subject: H-Net Review Publication: Fabbri on Haycock and Archer, ‘Health and Medicine at Sea, 1700-1900’
To: H-REVIEW@h-net.msu.edu

David Boyd Haycock, Sally Archer, eds.  Health and Medicine at Sea,
1700-1900.  Woodbridge  Boydell Press, 2009.  xiv + 229 pp.  $95.00
(cloth), ISBN 978-1-84383-522-6.

Reviewed by Christiane N. Fabbri (Yale University)
Published on H-Disability (January, 2013)
Commissioned by Iain C. Hutchison

Surgeons, Sailors, and Slaves in the British Royal Navy: Observations
of Maritime Medicine from 1700 to 1900

Naval medicine in the context of military, colonial, and social
history has become a growing area of historical enquiry, as evidenced
by the number of publications in the field within the past decade.
The nine essays presented in this volume are based on the 2007 series
of historical seminars sponsored by the National Maritime Museum in
Greenwich. Collectively, they highlight the important contribution of
maritime medicine to the development of the British Empire during the
eighteenth and nineteenth centuries. They explore the crucial role
naval surgeons played during this period in the advances in
sanitation and hygiene, surgical techniques, nutritional
deficiencies, and tropical diseases. They also underscore the growing
professionalization and prominence of naval medicine, starting with
the founding in 1694 of a hospital for old and disabled seamen in
Greenwich followed by the establishment of the Sick and Hurt Board
for taking care of sick and wounded seamen and prisoners of war,
through to its contributions in the fields of Laboratory Medicine and
Tropical Diseases at the end of the Victorian era.

The book is based on extensive original research, and includes a
valuable bibliography. Its contributors come from a broad range of
fields: social and cultural history, military and colonial history,
the history of science and medicine, psychiatry, and surgery. The
nine chapters of the collection are grouped around two central
themes: the first five are devoted to the practice and administration
of naval medicine in the Royal Navy, and to the crucial importance of
sailors’ health in war and maritime battles; the second four examine
health at sea in times of enforced migration, during the voyages of
slaves, convicts, and indentured or poor migrants.

The editor’s introductory chapter sets the stage from the opening of
the eighteenth century when the renowned London physician Richard
Mead reflected that “medicine still deal[t] so much in conjecture
that it hardly deserves the name of a science” (p. 1), to the end of
the nineteenth century, when after Louis Pasteur’s discoveries the
causative organisms of most common contemporary infectious diseases
had been identified.

The first chapter, an award-winning essay by medical historian Erica
Charters, discusses the inception of what may be some of the first
large-scale clinical trials conducted for the purpose of maintaining
and improving the health of seamen by the Sick and Hurt Board during
the Seven Years War of 1756 to 1763. Historians have attributed the
success of Britain during this war to the navy’s regular sending out
of fresh provisions; clearly, medical and naval officials recognized
that this was key to maintaining health and preventing disease among
sailors during long periods at sea. Contemporaries such as naval
physician James Lind understood diseases like scurvy to be the result
of a lack of fresh provisions, but still explained the disease itself
with traditional medical theories of putrefaction and lack of
adequate humors rather than lack of a specific substance, namely the
essential nutrient now known as Vitamin C, or ascorbic acid. It was
the initiative and systematic investigation by the Sick and Hurt
Board that led to the institution of early standardized experiments,
first in land hospitals, then at sea, where naval surgeons were
charged with evaluating the efficacy of the experiment. Their
findings led to effective new means of provisioning men at sea, such
as the issue to sailors of the widely popular “portable soup.” Most
likely this empirical approach was motivated as much by strategic
military concerns as by therapeutic ones. Nevertheless, as Charters
shows, in its quest to improve the health of seamen the Sick and Hurt
Board contributed significantly to the development of standardized
clinical research methodology.

John Cardwell’s essay, “Royal Navy Surgeons, 1793-1815: A Collective
Biography,” is part of an ongoing research project seeking to provide
insight into the geographic and social origins, medical training, and
professional expertise of the naval surgeons of the French Wars.
Contemporary caricatures of “middle-aged sawbones, driven to the Navy
by alcoholism or incompetence” (p. 38) are not borne out by the
extensive data culled from multiple primary sources, including
service registers and other Admiralty archives. Indeed, the
prototypical naval surgeon of the era, in spite of his usually
relatively modest background, received considerable education and
training, comparable to that of his civilian counterparts, including
apprenticeship as well as university and teaching hospital study.
Tracing the career paths of his cohort, the author demonstrates that
a considerable number of naval surgeons developed successful
practices after their naval service, with some, such as Scottish
surgeon and naturalist Sir John Richardson, garnering lasting fame
for their advancement of nineteenth-century science and letters.

Michael Crumplin, himself a retired surgeon, focuses on the practical
challenges faced by the ship’s medical officer after what, in the
author’s view, was often inadequate experience or haphazard training.
He describes the training and credentialing of naval surgeons, and
provides much interesting detail of their practice setting, including
allocation by rate of ship, daily practice and record-keeping
requirements, surgical instruments needed and supplied, together with
medicinal inventories and sick-bay and dispensary plans. While most
of the surgeon’s duties entailed the care of common ailments such as
gastrointestinal complaints, colds, and rheumatism, combat injuries
would rapidly overwhelm a lone practitioner with few or no
assistants, no matter how sophisticated his casualty triage system.
Until 1795, naval surgeons were able to fine their patients fifteen
shillings for presenting with venereal infections. These were
considered shameful but reportedly accounted for over 60 percent of
urinary tract complaints, and the protocol surely discouraged
consultation (p. 77). Ships medical officers were also called upon to
deal with gruesome battle wounds and perform major operations such as
limb amputations under extremely difficult conditions.

Pat Crimmin’s essay sheds light on how political contexts and cost
considerations influenced the activities and therapeutic choices of
the Sick and Hurt Board. Her painstaking study of the board’s
archival records helps explain some of the difficulties encountered
in improving naval medicine and sailors’ health, as well as the
board’s own ultimate demise when it was abruptly abolished in 1805.
The accusations were a deplorable state of its business, financial
slackness, and poor record keeping. After all, “medical men, by their
training, could not be expected to transact the business of accounts”
(p. 106).

At the end of the Napoleonic Wars, and over the half century
following the abolition of the slave trade, the career of a Royal
Navy surgeon had become so unattractive that it deterred most
volunteer candidates. The health of the navy and the working
conditions of seamen received equally little attention. Mark
Harrison’s essay details how the problems of naval antislavery
operations in tropical stations, and the high death rates of the
crews of the West Africa Squadron, ultimately focused public
awareness on the plight of sailors and brought about a turning point.
Thus the fateful Niger Expedition (1841-42) not only resulted in the
development of medical topography and quinine prophylaxis against
fevers, but also led to broader reforms of naval medicine and health,
including improved conditions for its surgeons. At the end of the
nineteenth century these efforts culminated in the founding of the
London School of Tropical Medicine. The formal study of tropical
diseases had grown out of what was originally a branch of the
Seamen’s Hospital Society.

A second section of four essays centers on the morbidity and
mortality that befell crew and passengers onboard slave ships and
during the enforced voyages of convicts and indentured laborers. The
death rates among such migrant populations were a consequence of
the often appalling and inhuman circumstances: overcrowding and
inadequate provisioning (to maximize profits) together with filthy
conditions. All this made fertile environments for the spread of
diseases such as dysentery, smallpox, and scurvy; it is estimated
that gastrointestinal diseases caused over 40 percent of such deaths.
Slave mortality during the so-called Middle Passage is reported to
have fluctuated widely, from about 10 percent to over 50 percent. In
1693, of 700 slaves bound for Barbados on the Royal Africa Company’s
ship Hannibal only 480 arrived alive. Decreases in death rates in the
transatlantic slave trade by the middle of the nineteenth century
reflect the direct impact of improved health conditions and the
critical role of the ships’ surgeons. Interestingly, mortality rates
of the crew, likely due to malaria or yellow fever contracted in West
Africa, remained unchanged over the same period of study.

The lessons learned by the Royal Navy of the eighteenth century were
gradually implemented during the transport of convicts and other
emigrants from Britain to Australia in the nineteenth century.
Legislation supporting strict sanitary guidelines for surgeons and
captains of government-commissioned ships resulted in much lower
passenger mortality rates during these voyages compared to those of
the much shorter, but unregulated, transatlantic crossings.

This book will be of interest to many historians, particularly those
working in the field of maritime and colonial history, and the social
history of medicine and public health. Clearly, maritime medicine in
the eighteenth and nineteenth centuries is “a rich subject, … ripe
for further investigation” (p. 17). Navy surgeons not only played an
important role in the health of their ship’s passengers, but also
made incontrovertible contributions to the development of
investigational medicine and public health. Future avenues of
research might profit from greater scrutiny of the veterans of
maritime service: the numerous retired and/or disabled sailors and
their physical and emotional sufferings, post-traumatic casualties of
the era.

Citation: Christiane N. Fabbri. Review of Haycock, David Boyd;
Archer, Sally, eds., _Health and Medicine at Sea, 1700-1900_.
H-Disability, H-Net Reviews. January, 2013.
URL: https://www.h-net.org/reviews/showrev.php?id=37836

This work is licensed under a Creative Commons
Attribution-Noncommercial-No Derivative Works 3.0 United States
License.